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Darrell S. Rigel, MD; Mark Naylor, MD; June Robinson, MD
From the Ronald O. Perelman Department of Dermatology, New York University Medical School, New York (Dr Rigel); the Department of Dermatology, Oklahoma Health Sciences University, Oklahoma City (Dr Naylor); and the Departments of Dermatology and Pathology, Loyola University Strich School of Medicine, Maywood, Ill (Dr Robinson).

Arch Dermatol. 2000;136:1447-1449.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

As we enter a new millennium, the use of evidence-based medicine, which uses the best current evidence to make decisions regarding patient care, to validate medical concepts has become increasingly important.¹ We applaud the ARCHIVES for instituting a regular section dedicated to this approach.

However, the credibility of the evidence-based method requires that the tenets of this approach be rigorously followed. In other words, the analysis must use the best current evidence to arrive at clinical recommendations.

Whether sunscreen use reduces the risk for melanoma has not yet been proved directly. However, inferential evidence strongly supports a protective effect. Since direct protective effects against skin cancer have been demonstrated only recently in humans,^2-4 some have suggested that sunscreen use might not reduce the risk for melanoma. The absence of direct proof has emboldened the most extreme critics to suggest that . . . [Full Text of this Article]

CONFUSION RESULTING FROM EXISTING STUDIES

Recall Bias

Interval Bias

Lack of Statistical Power

Surrogate End Point

Multivariate Analysis Needed

Sunscreen Use Needs to Be Better Defined

Conflicting Findings of Other Studies

WHAT NEEDS TO BE DONE TO DEVELOP AN EVIDENCE-BASED CLINICAL RECOMMENDATION REGARDING SUNSCREEN USE?

WHAT CLINICAL RECOMMENDATIONS CAN BE MADE FROM EXISTING DATA?


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